Anti-fluoride claims often not relevant to New Zealand

xiang-Endemic fluorosis

Much of the anti-fluoridation propaganda used by activists relies on studies done in areas of endemic fluorosis. Slide from a presentation by Q. Xiang to an anti-fluoride meeting organised by Paul Connett’s Fluoride Action Network in 2014.

As we head towards the parliamentary consideration of new legislation on fluoridation in New Zealand the anti-fluoride groups are building a campaign to oppose the transfer of responsibilities from local councils to District Health Boards. So, their Facebook pages are promoting myths that fluoridation is dangerous to health – and we expect this to intensify as parliament moves into its Health Committee hearings on the bill.

Also expect that the local anti-fluoridation groups, and their backers, will bring out tame “experts” to make presentations to the parliamentary Health Committee and to public meetings.

Has Connett lost his effectiveness in New Zealand campaigns?

Maybe (once again) Paul Connett or Bill Hirzy who are paid propagandists from the US Fluoride Action Network. An activist group financed by the US “natural”/alternative health industry. But perhaps these two are “old hat.” Connett has been making regular visits to Australia and New Zealand during the Southern Hemisphere summers for some time now and the locals have got a bit tired of him. Bill Hirzy accompanied him on last years summer vacation and really didn’t contribute much to the campaign. Thames overwhelmingly supported fluoridation in their referendum last year (see Thames voters decisively support fluoridation) – despite the highly publicised opposition by Connett and Hirzy).

A possible new anti-fluoridation “expert?”

susheela

Poster for an anti-fluoride meeting in Region of Peel, Canada. Image credit: Reiki with Christine

Perhaps local activists recognise this because they are floating ideas of bringing out a new “expert” – Dr A. K. Susheela. She might also have more credibility than either Hirzy or Connett – because, unlike them, she has actually published scientific papers on fluoride. In fact, she is the executive director of India’s Fluorosis Research and Rural Development Foundation – a small non-government organisation based in Delhi. The purpose of the foundation is to encourage awareness of fluorosis in both medical and local Indian communities to curb the spread of this crippling skeletal disease in India.

Susheela has also been doing  the circuit of anti-fluoride campaign meetings in North America (see, for example, ‘Fluoride is a deadly poison’ Peel’s water fluoridation committee has heard). As the poster above indicates, she is being promoted as an expert on fluoride toxicity and fluorosis.  But please note – this does not make her an expert on community water fluoridation.  All her work has concentrated on areas of endemic fluorosis – where dietary intake of fluoride is much higher than in fluoridated areas of New Zealand.

In a 1999 article for UNICEF (Susheela, A. K., Mudgal, A. (1999). Fluoride in water : An overview. UNICEF WATERfront, (13), 11–13.) she admitted:

“According to 1984 guidelines published by the World Health Organization (WHO), fluoride is an effective agent for preventing dental caries if taken in ‘optimal’ amounts.”

She went on to described the WHO recommendations for fluoride in drinking water:

“Water is a major source of fluoride intake. The 1984 WHO guidelines suggested that in areas with a warm climate, the optimal fluoride concentration in drinking water should remain below 1 mg/litre (1ppm or part per million), while in cooler climates it could go up to 1.2 mg/litre. The differentiation derives from the fact that we perspire more in hot weather and consequently drink more water. The guideline value (permissible upper limit) for fluoride in drinking water was set at 1.5 mg/litre, considered a threshold where the benefit of resistance to tooth decay did not yet shade into a significant risk of dental fluorosis.”

For comparison, the target fluoride concentration for community fluoridation in New Zealand is about 0.7 – 1.0 mg/litre. The natural levels of fluoride in New Zealand’s drinking water are even lower. There is no significant risk of skeletal or dental fluorosis of concern due to CWF, or natural levels of fluoride,  in New Zealand.

Dr Susheela has no expertise in the area of community water fluoridation – or areas of the world where drinking water fluoride levels are similarly very low. Perhaps this is why she made the mistake of including Australia and New Zealand among countries where fluorosis is endemic in the above article which included the map below.

susheela-unicef

Dr Susheela is mistaken about fluoride in New Zealand and Australia. Map from her article 

Fluoride Freee NZ disingenuously used this mistake to claim that New Zealand suffered from endemic fluorosis – and cited UNICEF in support.  I would hope that Dr Susheeela, if she does come to New Zealand to campaign against the upcoming fluoridation bill, publicly admits and apologises for this  mistake.

Conclusion

We are used to anti-fluoride campaigners misrepresenting the scientific research on the efficacy and possible health effects of community water fluoridation. But we should also be wary of their claims derived from research in areas of endemic fluorosis where dietary intake of fluoride is much higher than in New Zealand. This includes studies on possible IQ effects and skeletal fluorosis.

The research may be respectable – but the findings are just not relevant to countries like New Zealand where the drinking water fluoride concentrations (in fluoridated and unfluoridated areas) is much lower.

Similar articles

 

Advertisements

80 responses to “Anti-fluoride claims often not relevant to New Zealand

  1. Ken,

    You are missing a key point which is that fluoridation should be optional, just like vaccination.

    I am not aware that an absence of fluoride in water ever killed anybody. I am sure you would be the first to agree that we should know what we’re eating and have the choice not to eat something we don’t want or like.

    Vaccination isn’t compulsory and neither should it be. Neither should fluoridation. There is of course this tremendous invention which has been around for a long time which can help with oral health. It’s called toothpaste. It doesn’t require being swallowed to be effective.

    Liked by 1 person

  2. The following are notes taken at the “expert” Susheela’s Peel presentation. I have no name to which to attribute these notes, so take them for whatever they may be worth:

    Comments/quotes from Dr. Susheela:

    • Other countries have stopped fluoridating 30 years ago. The reason is health problems.
    • Many developing countries across the globe have natural fluoridation…naturally poisoning people
    • “you are adding and we are removing”
    • WHO says fluoride is good for teeth but West Africa brought it down to 0.6 ppm. Then China to .5 then Thailand
    • India’s fluoride was 48 mg/L. “poison of the highest order”. Children getting dental fluorosis
    • 2012 India brought forward a drinking water act/standard to 1mg/L with a rider-less the better as fluoride is injurious to health
    • Dr. Susheela acknowledged 1mg/L is the upper limit the body may tolerate.
    • India did not put a lower limit because they didn’t want the professionals to be taken to court.
    • Fluorisis was found even with .3 and .5 ppm “poison water”
    • WHO guideline is 1.5 mg/L is desirable. “What is so desirable to a poison?” she asked. She said WHO is just a guideline, every country is to develop a standard.
    • In the US-water quality standard act set in 1962. Adding fluoride up to 4mg/L. In India at this level “our people were paralyzed”-“policy makers don’t want to hear this”.
    • Policy makers should determine what the policies are in their own country.
    • 0.7 ppm fluoride is what CDC in Atlanta endorses.
    • “they did it silently from 4 to 0.7 so that people wouldn’t sue”
    • “You have seen Africian children on the TV, they look terrible, they have no brains” (due to fluoride).
    • Why do they fluoridate? “Many professionals and policy makers aren’t knowledgeable…they have no time to read”.
    • Thought to be preventing dental caries, but it is “mass medication”, “unethical”
    • There is “no such thing as fluoride deficiencies, they are misleading you”
    • dental carries are nothing but bacterial disorder
    • “fluoride is not the answer”
    • “dental professionals confuse people”
    • “myth not science”
    • “fluoride is not making tooth stronger, in reality it makes it weaker”
    • There is ample scientific evidence available that caries can be prevented through oral hygiene practices
    • “dental professionals are only concerned about the oral cavity, they’re not the least bothered by what happens below the neck”
    • Times have changed, there is 75 years of research
    • Fluoride is a “deadly chemical, deadly poison”
    • She spoke of the health risks first identified. Skeletal fluorosis-first found in cattle and dental fluorosis. Bones and teeth affected.
    • After discovered soft tissue fluorosis-kidney, liver, spleen- “no tissue is spared by this deadly poison”
    • Many disorders affected by fluoride
    o Linked diseases-fluoride toxicity-early manifestations. Irritable bowel syndrome-if a patient comes to a doctor with IBS-she suggested they should suspect fluoride poisoning as one of the problems. Polyuria, polydipsia, as well as severe muscle weakness, anemia, kidney failure, cancer.

    • Recommended serum fluoride levels-get blood taken to get fluoride levels; urine fluoride levels; also test the water and then also take a forearm xray. Once confirmed, results will show fluoride poisoning/contamination
    • Fluoride is a neurotoxin, hormone receptor, enzyme inhibitor
    • ? why doesn’t everybody get affected. No two individuals are alike therefore body determines who is more sensitive.
    • GI system totally damaged structurally and functionally by fluoride
    • “doctors in this country don’t read. Unfortunate part of our education system here”
    • Fluoride poisoning leads to constipation
    • “skeletal fluorosis and arthritis is the same”

    Steven D. Slott, DDS

    Like

  3. By the way, Ken, I assume you weren’t one of those who complained about anti-fluoridation adverts which were factually correct. Why would someone want to complain about the facts?

    http://www.scoop.co.nz/stories/PO1610/S00031/fluoride-free-nz-wins-on-advertising-complaints.htm

    Liked by 1 person

  4. Mary Byrne, media spokesperson for Fluoride Free New Zealand said, “We are pleased with the ASA ruling but are becoming increasingly concerned with the antics of the pro-fluoridation activists. Complaining about these adverts shows they don’t even believe in freedom of speech. Especially the advert that simply tells people a few facts about how many countries have water fluoridation. How can anyone complain about that? These complaints strike at the heart of our democracy.”

    Ken, I trust you believe in freedom of speech?

    Liked by 1 person

  5. Susheela is being promoted by antis as the “foremost authority on fluoride in the world”. I’m not quite sure how that works with Connett being the “Premier International Authority on Fluoridation”, but I suppose their people have coordinated their titles and turf in some mutally agreeable manner. Perhaps they alternate days or something.

    Steven D. Slott, DDS

    Like

  6. It is truly riotous to see Mary Byrne and her “fluoridefreewhatever” branch of “FAN”, exhibiting such contempt at fluoridation proponents questioning the veracity of their claims.

    That’s like the Pope exhibiting shock at being accused of having Catholic beliefs.

    Has anyone ever counted the number of true statements made by these antifluoridationists to see whether it takes one hand or two?

    Steven D. Slott, DDS

    Like

  7. Ross, perhaps you should read my post again.

    1: It is about the use of research from areas of endemic fluorosis in the campaign against community water fluoridation. Such research is of no relevance and therefore it6s use is a form of misrepresentation.

    2: Sure, the absence of fluoride or calcium in drinking water may not have killed anyone – and no one says it has, so that is a red herring.
    However, both ions are known to be beneficial in limiting tooth decay when present in optimum amounts in drinking water.

    3: Fluoridation in NZ is optional – it depends on community consultation. It is also effectively “optional” at the personal level as it is up to the individual to use alternative sources or water filters if they wish to remove anything they have a hangup about from their drinking water.

    Do you use water straight from the tap? Do you use a filter? Do you use an alternative source? Have you ever been held down and had tap water forced down your throat?

    4$: Yes, fluoridated toothpaste is certainly helpful – but your mates also campaign against that, don’t they.
    However, research shows fluoridated water has a positive effect above and beyond the use of fluoridated toothpaste. This is because it helps maintain the concentration of fluoride in saliva at an effective level throughout the day – not just in the hour after toothbrushing.

    Like

  8. No, I wasn’t involved in those unsuccessful complaints. It is notable, though, that FFNZ has some sort of record for findings against their advertising by the Advertising Standards Authority (ASA). They are simply crowing about this one because it is one of the few that did not rule against them.

    I do not think the ASA has the scientific skill to make judgements on the science and that is why they often reject valid complaints and then back down to the appeals. It is interesting that in the ruling you are crowing about the Chairman said

    “the existence of contradictory evidence – even if that evidence was against the view of the consensus – did not mean an advertisement was misleading, as long as the identity of the Advertiser was clear.”

    In other words – the advertiser can be factually wrong as long as they identify themselves so that it is clear that the message is biased.

    Like

  9. Yes, Ross, I support freedom of speech – and that is surely obvious from the large number of critical comments I get here. You are simply taking advantage of the fact I support freedom of speech.

    But, do you support freedom of speech?

    If you do could you please raise this issue with your mates in FFNZ and the Fluoride Action Network as they ban me and others from commenting on their websites and Facebook pages.

    Why do you think they prevent scientific critique on their pages? Not only do they oppose freedom of speech they are terrified of being challenged in their lies and misinformation.

    Like

  10. Ken,
    When “dental fluorosis” is taken to mean white opacities on teeth, the fluoridation in NZ does not show up much effect, I understand.

    So it plays into the hands of fluoridationists to call all white opacities on teeth “dental fluorosis.”

    Only some of the damage to the ameloblasts is done by fluoride. When fluoride causes “dental fluorosis” the appearance is diffuse and rather symmetrical in the mouth. That is as opposed to other trauma such as fillings to first teeth which cause “demarcated” “dental fluorisis” in the permanent teeth which is incorrectly labelled as “fluorosis”. And it is not symmetrical in the mouth.

    Note in this study “diffuse” opacities are being considered.
    “In Auckland, New Zealand, Cutress et al. found that diffuse enamel opacities occurred more frequently in fluoridated than nonfluoridated areas (P<O.OOl), with a mouth prevalence of 19 percent in the fluoridated areas, but only 8 percent in the nonfluoridated areas."

    https://deepblue.lib.umich.edu/bitstream/handle/2027.42/66368/j.1752-7325.1987.tb01980.x.pdf?sequence=1&isAllowed=y

    Liked by 1 person

  11. Steve Slott “quote” from Susheela:
    “fluoride is not making tooth stronger, in reality it makes it weaker”

    There is a common misconception that the white opacities on teeth are something strong added by fluoride.

    Teeth are built by an amazing process in which “ameloblasts” coordinate deposition of calcium and other minerals as tooth enamel before the tooth comes through. When fluoride or trauma damages the process then the mineralisation does not occur properly. “Hypomineralisation,” occurs, “hypo” meaning “under” or “insufficient.” White marks or brown ones can result I think where protein is left behind instead of calcium hydroxyapatite. So the tooth be not so strong.

    Living organisms can concentrate elements of the “halogen” group. Sea weed concentrates iodine many times from sea water. The human mother’s milk is very low in fluoride but the fetus/infant concentrates the necessary amount in the forming tooth. A small amount in the crystalline enamel makes the tooth somewhat more acid resistant. That is “strength” in a sense I suppose.

    Like

  12. Steve Slott “quote” from Susheela:

    “? why doesn’t everybody get affected. No two individuals are alike therefore body determines who is more sensitive.”

    Indeed.

    I ask a few questions: Why can people understand that a car motor needs tuning in accordance with its particular specifications and climate and mode of use, but cannot understand the same for humans so easily?

    Please treat humans humanely, in accordance with their particular organism and conditions.

    Why can you laugh if it be proclaimed that in future garages will only sell petrol suited to low compression cars?

    Like

  13. Your usual ad hominem about Paul and Bill – and yet you ask that comments don’t do just that! The fact that Paul has managed to make regular visits to NZ for the past 15 years shows his commitment to opposing fluoridation which he appears to me, quite rightly, to find absolutely disgusting. Far from being ‘old hat’ Paul always brings the background in toxicology from his work in incinerator technologies, that is sadly lacking in most medicos promoting fluoridation – indeed that last doctor I stole to about this didn’t even know the fluoride came from the filthy chimneys of the phosphate fertiliser factories.
    Dr John Colquhoun put the incidence of dental fluorosis in Auckland children at 30% I believe, and predicted it could well affect 50% by now, and that definitely seems possible to me just looking at the numbers of adults now with mottled teeth – the first obvious sign of fluoride poisoning – so I would call that ‘endemic’ – wouldn’t you?

    Like

  14. Soundhill

    You really aren’t trying to lecture a dentist on dental fluorosis with your unsubstantiated personal opinions, and what you “think” might be occurring, are you? What’s next….your lecturing NASA engineers on the nuances of space exploration?

    1. Dental fluorosis is not “taken to mean” anything. It is an effect of the teeth caused by systemic fluoride during the teeth developing years of 0-8. Trauma does not cause dental fluorosis, “demarcated” or otherwise.

    There are distinct levels of dental fluorosis: very mild, mild, moderate, and severe. The only level which may be associated with optimally fluoridated water is mild to very mild. This is characterized by barely detectable faint white streak on teeth which cause no adversity on cosmetics, form, function, or health of teeth.

    The only level. of dental fluorosis considered to be an adverse effect is severe. This level is characterized and defined by brown stains and pitting. It does not occur in communities with a water fluoride content of 2.0 mg/liter or less. Water is fluoridated at 0.7 mg/liter, one third that level.

    Mildly fluorosed teeth have been clearly demonstrated by peer-reviewed science to be more decay resistant.

    “The results of this study suggest that teeth with fluorosis were more resistant to caries in U.S. schoolchildren than were teeth without fluorosis. Our results highlight the need for those considering policies regarding reduction of fluoride exposure to take into consideration the caries-preventive benefits associated with milder forms of enamel fluorosis.’

    —The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren Hiroko Iida and Jayanth V. Kumar
    J Am Dent Assoc 2009;140;855-862

    2. There is no valid, peer-reviewed scientific evidence of any sensitivity to optimal fluoride.

    3. The level of fluoride associated with water fluoridation is below the threshold of adverse effects for anyone, of any age. It therefore doesn’t matter that “no two individuals are alike”, nor does it matter what is their “particular organism and conditions”. Optimal level fluoride has no adverse effect regardless of these two variables.

    Even Susheela, herself, acknowledges that fluoride at 1.0 mg/liter “is the upper limit the body may tolerate.” Water is fluoridated at 0.7 mg/liter.

    Steven D. Slott, DDS

    Like

  15. WonderMouse

    If I pretended to be “opposing fluoride” do you think “FAN” would pay my expenses for numerous trips to NZ and Australia during our winter here in the US? How about trips to Europe? I had a very nice trip to Europe a few years ago. Unfortunately, I wasn’t as creative as Connett, and had to pay for it myself.

    Do you think maybe the doctor with whom you spoke, “didn’t even know that the fluoride came from the filthy chimneys of the phosphate fertiliser factories” is for the same reason that he probably didn’t even know that the moon is made of green cheese?

    Steven D. Slott, DDS

    Like

  16. Steve Slott, from your cite:
    “Results

    Permanent maxillary right first molars with fluorosis consistently had lower levels of caries experience than did normal molars. Adjusted odds ratios for caries prevalence in molars with fluorosis were 0.71 (95 percent confidence interval [CI], 0.56–0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74–1.06) in communities with water at or above optimal fluoridation levels.”

    So in an “optimally” fluoridated area, “dental fluorosis” is related on average to 11% less decay. But a few of the people in the 95% confidence interval can have 6% more decay if they have fluorosis, according to that study.

    That is from the study you cite. Now here is a better study which actually cites the one you cited.
    https://www.researchgate.net/profile/Jaime_Castellanos/publication/305670743_Higher_Fluorosis_Severity_Makes_Enamel_Less_Resistant_to_Demineralization/links/579a190008ae425e491832c5.pdf

    Higher fluorosis => less resistant enamel.

    ” The findings suggesting that mild to moderate fluo-
    rotic enamel (TF3–4) is less resistant to demineralization
    highlight the importance of monitoring the systemic flu-
    oride exposure to reduce the risk of developing moderate
    to severe dental fluorosis while preserving its caries con-
    trol beneficial effect. They also support the current con-
    cept about the fluoride cariostatic mechanism on caries
    lesion reduction, demonstrating that firmly bound fluo-
    ride does not make enamel more resistant to demineral-
    ization, emphasizing the relevance of the local effect of
    low fluoride concentration in the oral cavity ”

    But click and read on.

    There may be a little doubt but to me it looks unfair to have infants high on fluoride from water and toothpaste, since their later permanent teeth can become mildly fluorotic and less resistant to decay.

    So don’t have infants drinking fluoridated water.

    As regards diffuse vs demarcated fluorosis, Broadbent also studied it. They even suggested that because fluoride might reduce decay in baby teeth, there could be reduction in fillings or trauma to them, resulting in less “fluorosis” or enamel opacity of the permanent teeth. Though I suggest it should be of the non-symmetrical type.

    Better read up before getting dogmatic, Steve.

    Like

  17. Wonder Mouse – what a strange response. My comments on Hirzy and Comment were the following:

    “Maybe (once again) Paul Connett or Bill Hirzy who are paid propagandists from the US Fluoride Action Network. An activist group financed by the US “natural”/alternative health industry. But perhaps these two are “old hat.” Connett has been making regular visits to Australia and New Zealand during the Southern Hemisphere summers for some time now and the locals have got a bit tired of him. Bill Hirzy accompanied him on last years summer vacation and really didn’t contribute much to the campaign. Thames overwhelmingly supported fluoridation in their referendum last year (see Thames voters decisively support fluoridation) – despite the highly publicised opposition by Connett and Hirzy).”

    What the hell is ad hominem about that? I have not attacked either of these persons simply pointed out some facts.

    They are paid by big business.

    Connett has been regularly visiting and campaigning in NZ during the southern summer.

    Given the results of recent referenda in NZ, his campaigns do not seem to be effective. Locals do seem to treat him as “old hat” – and I can understand why FFNZ might want to choose another “expert” like Susheela who has at least published scientific papers on fluoride (Connett hasn’t and Hirzy’s attempts were hilarious – very few authours have had to withdraw a paper as quickly as he did because of the faulty arithmetic).

    Like

  18. Wonder Mouse – When fluoride additives completely dissociate, when fluoride ions are identical regardless of source and when contaminants from fluoridation agents are tested to be far below regulated levels it makes no difference where the additives originate.

    I became motivated to participate in countering the anti-F claims last year when fluoridation opponents from all over descended on Denver and initiated their campaign to shut down fluoridation of Denver water. Top anti-F propagandist {at that time}, Paul Connett, was even brought in to present the anti-F agenda during a public information session.

    Following the session, the Denver Water Board concluded, “After reviewing the presentations, the extensive research on this issue, and the advice of public health and medical professionals in Colorado, the board announced there would be no change in its water fluoridation policy.”

    The resolution the board adopted at its meeting stated: “Nothing we heard through the presentations or learned in research would justify ignoring the advice of the public health agencies and medical organizations or deviating from the thoroughly researched and documented recommendation of the U.S. Public Health Service.”

    Denver Water Commissioner Greg Austin went on record saying, “After careful consideration of the information put forth by both sides of the fluoridation debate, I am convinced that the community water fluoridation level recommended by the U.S. Public Health Service provides substantial health benefits, and is a safe, cost-effective and common sense contribution to the health of the public.”
    https://denverwaterblog.org/tag/community-water-fluoridation/

    It does not matter whether “Paul always brings the background in toxicology from his work in incinerator technologies…” when his presentations (in which he promoted his book twice) provided standard, anti-F propaganda and no legitimate evidence to prove his opinions are valid.
    This is a response to another Connett presentation.
    http://mail.cornwall.ca/Active/Development/egenda.nsf/965d04e85bb82eb4852573ae007b4532/ca04cc8dd7590f4285257f770072ef20/$FILE/ATTLRG3N.pdf/Response%20to%20Connett%20by%20AFS.pdf

    Like

  19. Soundhill

    1. I see no dogma in my comment

    2. You are claiming that fluoride makes teeth weaker. Iida and Kumar demonstrated just the opposite in teeth which have been chronically exposed to systemic fluoride during the teeth developing years, at the level which causes mild dental fluorosis. There is nothing in this study that demonstrates that mildly fluorosed teeth are less resistant to decay.

    “Our analysis showed that first permanent molar teeth with fluorosis consistently had lower caries experience than did molars without fluorosis. These data are consistent with those of two previous studies conducted in the United States that showed that teeth with mild fluorosis are more resistant to caries. Our finding that even molars with moderate-to-severe fluorosis had lower caries prevalence than did teeth without fluorosis is consistent with that reported by Eklund and colleagues. In contrast, Driscoll and colleagues found a higher proportion of teeth with severe fluorosis to be decayed or filled, a finding they attributed to pitting of teeth, staining of teeth or both. Such surface imperfections are not present in teeth with mild fluorosis.”

    —The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren Hiroko Iida and Jayanth V. Kumar
    J Am Dent Assoc 2009;140;855-862

    3. Because you perceive a study to better support your confirmation bias does not make it a “better” one.

    Marin, et al. concluded that their findings suggested that as the level of dental fluorosis increases, the less the resistance to decay. The 2006 NRC Committee on Fluoride in Drinking Water classified severe dental fluorosis to be an adverse health effect, for this very reason. The pitting characteristic of this level of dental fluorosis can make those teeth more susceptible to decay. There is no such pitting in very mild, mild, and moderate dental fluorosis. Therefore, these levels are not considered to be an adverse effect.

    “The findings suggesting that mild to moderate fluorotic enamel (TF3–4) is less resistant to demineralization highlight the importance of monitoring the systemic fluoride exposure to reduce the risk of developing moderate to severe dental fluorosis while preserving its caries control beneficial effect. They also support the current concept about the fluoride cariostatic mechanism on caries lesion reduction, demonstrating that firmly bound fluoride does not make enamel more resistant to demineralization, emphasizing the relevance of the local effect of low fluoride concentration in the oral cavity [Fejerskov et al., 2015]. This can be obtained by daily drinking of fluoridated water or regular toothbrushing with fluoride toothpaste [Cury and Tenuta, 2008].

    —-Higher Fluorosis Severity Makes Enamel Less Resistant to Demineralization
    Marin, et al.
    Caries Res 2016;50:407–413

    4. The only “risk” to infants from optimally fluoridated water is very mild to mild dental fluorosis in developing teeth when reconstituting powdered formula with this water. Mild dental fluorosis is barely detectable and has no adverse effect on cosmetics, form, function, or health of teeth. For those parents who are concerned with even mild dental fluorosis, in spite of the greater resistance to decay of these teeth, the ADA and the CDC have suggested they use non-fluoridated water to reconstitute this powder, or simply use pre-mixed formula, most, if not all, of which is made with low fluoride-content water.

    Steven D. Slott, DDS

    Like

  20. Steve Slott,
    A lot of researchers have noted a small correlation between fluorosis and less decay. Then it has been suggested correlation is causation and it has been repeated like a dogma.

    Now you and I have both quoted the same bit from Marin. Rather than relying on correlation they have done experiments on teeth. So their work is better. They have found the opposite to the dogma.

    Those relying on just the correlation are forgetting that fluorotic teeth will also be in an area where fluoride is higher. The reduction in caries is not a result of fluorotic teeth but of the fluoride helping to remineralise teeth already grown. Fluorosis and less decay are independently connected to the third variable of fluoride.

    Marin found even mild fluorosis weakens teeth.

    I don’t think you to be correct about infants only being at risk if their formula is made from fluoridated water. Infants are also given water to drink. Some are weened earlier, too. They drink a lot per body weight compared to older children. And they are drinking it when the permanent teeth are still forming.

    Fluoridation is claimed to be aimed at poorer families, and they will not be the ones able to afford filters.

    While our diets contain starchy food which sticks to the teeth and prevents saliva getting to them to remineralise them then we ought to give children every chance of good teeth by encouraging brushing with a soft brush to remove the food from teeth and gums and allow saliva to them. The toothpaste should not be strongly abrasive and that is not necessary to remove food. Then a proper integument will remain on the teeth with microbiome concentrating from saliva the fluoride, magnesium and calcium on the tooth surface.

    We should not be trying to mistakenly force fluoride into growing teeth because Marin has shown that has the reverse effect.

    Like

  21. Steve Slott, It is not I claiming it to be a better experiment it is the researchers: “The results differ from the literature [Kidd et al.,
    1980; Waidyasekera et al., 2007; Suma et al., 2008; Alhawij
    et al., 2015], possibly due to the improvements in our ex-
    perimental design: (1) The analysis of the demineraliza-
    tion resistance of fluorotic enamel considered the base-
    line mineral content due to the hypomineralization of
    fluorotic enamel to calculate its change after demineralization induction; (2) the natural fluorotic enamel surface
    was preserved, and (3) the method to induce demineral-
    ization mimics the natural process of caries development.
    The lower resistance of TF3–4 teeth to the induced caries
    process cannot be explained by whole enamel mineral
    content because the groups did not differ in Ca and P i
    concentration ( table 1 ). In contrast, if the structurally in-
    corporated fluoride protected enamel against demineral-
    ization [Takagi et al., 2000], a greater resistance of fluo-
    rotic teeth would be expected due to their higher enamel
    fluoride concentration compared with sound teeth ( ta-
    ble 1 ). However, neither the higher fluoride concentra-
    tion found at the enamel surface ( fig. 1 a) nor in the whole
    enamel area ( fig. 1 b) conferred resistance to the simulated
    caries process. The absence of a cause-effect relationship
    between fluoride concentration structurally incorporated
    in enamel and its demineralization may be explained by
    the fact that we found in the whole enamel only 0.009%
    fluoride, and 60% structurally bound fluoride (around
    29,000 ppm) is required to cause drastic mineral acid sol-
    ubility reduction.” Please click and read on:
    https://www.researchgate.net/profile/Jaime_Castellanos/publication/305670743_Higher_Fluorosis_Severity_Makes_Enamel_Less_Resistant_to_Demineralization/links/579a190008ae425e491832c5.pdf

    Like

  22. Soundhill

    1. Your opinion as to what constitutes a “small correlation” is driven by your confirmation bias, and is irrelevant. That you consider peer-reviewed scientific evidence to be “dogma” is not surprising, but bears no relevance to reality.

    2. Iida and Kumar “examined the association between enamel fluorosis and caries using logistic regression analysis, controlling for potential confounders in communities with water at or above optimal fluoridation levels and in communities with nonfluoridated or suboptimally fluoridated water.”……on the population level, utilizing the Dean Index.

    Marin examined extracted unerupted third molars……on the specific tooth level, utilizing the Thylstrup and Fejerskov Index.

    To say one or the other is “better” is saying oranges are better than apples.

    3. Marin found highly fluorotic teeth at the T3-T4 level to be less resistant to decay than those at the T1 level. T3-T4 correspond to moderate in the Dean Index. Iida/Kumar found mildly fluorosed teeth to be more decay resistant.

    There is nothing in Marin which contradicts the findings of Iida/Kumar.

    4. Dental fluorosis is an indicator of fluoride exposure during the teeth developing years of 0-8. It doesn’t matter whether they are in “an area where fluoride is higher”, whatever you deem that to mean.

    5. Marin found that T3-T4 were less resistant to decay. This does not equate to the “mild” level of Dean, which was used by Iida/Kumar.

    6. If you have valid, peer-reviewed scientific evidence of any adverse effect on infants from optimally fluoridated water, then feel free to present it, properly cited.

    7. Optimal level fluoride is colorless, tasteless, odorless, and causes no adverse effects. There is no valid scientific need for anyone to filter fluoride from their water unless that fluoride exceeds 2.0 ppm. Anyone who chooses to do so is entirely free to purchase filters, bottled water, or whatever they want. However, any expenses involved in so doing are not the responsibility of society to bear.

    8. Water fluoridation does not preclude the need for proper oral hygiene, nor does its implementation suddenly cease educational efforts in proper home care which have been ongoing for the past century, and will continue to be ongoing through infinity. No matter how much education is provided, however, it will still depend on compliance. Water fluoridation has no compliance issues. This is one of the strongest assets of this initiative. It provides ongoing dental decay prevention even when compliance with other preventive measures breaks down.

    Steven D. Slott, DDS

    Like

  23. Steve Slott: “Dental fluorosis is an indicator of fluoride exposure during the teeth developing years of 0-8. It doesn’t matter whether they are in “an area where fluoride is higher”, whatever you deem that to mean. ”

    If they got real fluorosis (and not just white marks from some sort of trauma to the baby tooth above or from antibiotic use or chickenpox &c) then fluoride is a likely cause, whether in the food, air, or swallowed toothpaste.

    The exposure is likely to go on and if in food, toothpaste, or water help, with remineralisation of teeth and reduce decay. So how do you suggest Lida/Kumar dealt with that confoundment? Did they track children who stopped using fluoridated toothpaste at age 7 and moved to a low fluoride water supply?

    And Marin went further pp.411-412:
    “The absence of a cause-effect relationship
    between fluoride concentration structurally incorporated
    in enamel and its demineralization may be explained by
    the fact that we found in the whole enamel only 0.009%
    fluoride, and 60% structurally bound fluoride (around
    29,000 ppm) is required to cause drastic mineral acid solubility
    reduction [Poulsen and Larsen, 1975].” Please go to article and read on.

    Note 29,000 parts per million is 2.9%.

    Like

  24. Steve Slott: “Marin found highly fluorotic teeth at the T3-T4 level to be less resistant to decay than those at the T1 level. T3-T4 correspond to moderate in the Dean Index. Iida/Kumar found mildly fluorosed teeth to be more decay resistant.

    There is nothing in Marin which contradicts the findings of Iida/Kumar. ”

    The T index, or rather TF (Thylstrup Fejerskov) is claimed to be better than Deans. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0528.1978.tb01173.x/full

    It is a 10 point scale. Most “questionable” fluorosis under the Dean Index classifies as a TF score of 1; most “very mild” fluorosis classifies as TF 2 or 3; most “mild” fluorosis is a TF 3 or 4, most “moderate” fluorosis is a TF 4, and all severe fluorosis is a TF 5-9. (Mabelya 1994).

    TF 0 of course being no fluorosis.

    Contrary to what you claim, Steve, the Marin study works with TF 3 -4
    (Deans mild), not TF 4 (Deans moderate).

    But looking at Marin’s figure 2 even TF 1 – 2 (between Deans questionable and very mild) there is increased loss at 50 micrometers following pH cycling.

    Like

  25. Steve Slott: “To say one or the other is “better” is saying oranges are better than apples.”

    Not really because that analogy does not take into account that Marin et al in 2016 have developed an experiment to overcome the uncertainties of Iida/Kumar 2009 study and others. Holding on to the old results is dogmatic.

    “While Lida and Kumar [2009] demonstrated that fluorotic
    teeth of individuals living in an area with belowoptimal
    fluoridated water have less caries experience,
    Driscoll et al. [1986] demonstrated that only severe fluorotic
    teeth have more caries experience than those without
    fluorosis. The latter could be explained by confounding
    factors, such as the current widespread use of fluoridated
    toothpaste [Cury and Tenuta, 2008].” see Marin for that and more p. 408.

    Like

  26. Ken’s repeated assertion, that Dr Susheela’s profound expertise in the chronic health hazards of of fluoride in India has no relevance to New Zealand, has no basis in science or logic. Science is international, not provincial. Some of the regions in India where skeletal fluorosis is observed have fluoride concentrations in drinking water in the range 1.2-1.6 ppm. These observations have been published in leading medical journals. Since there is wide variation in drinking water ingestion, there can be no doubt that New Zealander’s with high water intake will have daily fluoride doses overlapping with those of some Indians who have skeletal fluorosis. Fluoridation of drinking water to concentrations around 1 ppm provides no safety margin for chronic effects. In toxicology a safety margin (in concentrations) of a factor of 100 is recommended, comprising a factor of 10 to allow for variations in dose multiplied by a factor of 10 to allow for variations in individual sensitivity. But fluoride, as an “existing chemical”, is exempt from toxicological constraints.
    Furthermore, as the Cochrane Review states, there are no randomised controlled trials proving benefits of water fluoridation (although there are hundreds of public relations ‘demonstrations’ with pre-determined outcomes by fluoridation proponents). Furthermore, experiments on both humans and mice suggest that there is no dental benefit from actually ingesting fluoride. Whether there is any slight topical benefit from 1 ppm fluoridated water passing over the teeth is unresolved scientifically.
    By the way, I have published scientific assessments of fluoridation in leading international peer-reviewed journals, including Nature.

    Like

  27. Sure, Mark, science is international – I have a background in scientific research so am well aware of that. But the science also tells us that results vary with conditions –and conditions often vary from country to country. That is why the WHO recommendations on fluoride change as the drinking water concentration moves from 1.5 mg /litre. Surely you are aware of that.

    The NZ generally recommended optimum concentration for fluoride in drinking water is 0.75 mg/litre – well below the concentrations Susheela deals with for areas of endemic fluorosis. She made a clear mistake when she included New Zealand on her map of countries suffering endemic fluorosis – we just don’t.

    Unsurprisingly we do not observe skeletal fluorosis in New Zealand and it is disingenuous to suggest that New Zealand is at all similar to Indian areas of endemic fluorosis.

    As you point out, the naïve concept of “safety margin” is not relevant to fluoride as it is a naturally occurring chemical in all drinking waters in New Zealand. Here, the only observed negative health effect of community water fluoridation is a possible (often statistically insignificant) increase in the mildest forms of dental fluorosis. These are not of cosmetic or health concern and are usually judged favourably by parents.

    Mark, I am surprised that as someone who has published in internationally peer-reviewed journal (and therefore should have some concept of the ethical issues around citations) you should misrepresent the Cochrane fluoridation review and think you can pull the wool over my eyes with the old “randomised controlled trials” chestnut. The Cochrane review pointed out:

    “However, there has been much debate around the appropriateness of GRADE when applied to public health interventions, particularly for research questions where evidence from randomised controlled trials is never going to be available due to the unfeasibility of conducting such trials. Community water fluoridation is one such area.”

    I you wish to pursue the real situation regarding the Cochrane review you can consult some of the articles I have written on it here.

    You are also disingenuous in your comments about dental benefits. In fact there is plenty of research showing that consumption of fluoridated water significantly reduces tooth decay. Some of that research shows benefits due to ingestion in the case of developing and pre-emergent teeth. But there is clear evidence of benefits from the reaction at the surfaces of existing teeth due to increase concentrations of fluoride in saliva s resulting from consumption of fluoride containing food and drink.

    You are completely wrong (some would say dishonest) to claim this benefit is “unresolved scientifically.”

    Mark, if you wish to pursue these issues in more detail I am prepared to offer you a right of reply to this article – or space for a series of articles where we can discuss the published literature – along the lines of the discussion I had with Paul Connett (see the Fluoride Debate).

    Like

  28. Ken: “She made a clear mistake when she included New Zealand on her map of countries suffering endemic fluorosis – we just don’t.”

    In the Journal of Public Health Dentistry,
    (for which I gave the URL)
    Vol. 47, No. 2, Spring 1987
    Susan M. Szpunar, MPH*
    Brian A. Burt,
    BDS, MPH, PhD
    Program in Dental Public Health
    School of Public Health
    The University of Michigan Ann Arbor,

    wrote:
    “In Auckland, New Zealand, Cutress et al. found that diffuse enamel opacities occurred more frequently in fluoridated than nonfluoridated areas (P<O.OOl), with a mouth prevalence of 19 percent in the fluoridated areas, but only 8 percent in the nonfluoridated areas."

    Ken, what do you call that if not endemic fluorosis?

    Like

  29. I don’t call it endemic fluorosis – and neither did Szpunar and Burt.

    Like

  30. Ken, the Szpunar and Burt paper only had the term “endemic” in its citations.
    “Studies on the minimal threshold of the dental sign of chronic endemic fluorosis (mottled enamel)
    HT Dean, E Elvove – Public Health Reports (1896-1970), 1935 – JSTO”
    That would be Dean of the Dean’s Index.
    The paper says:

    “Since the publication of the results of three independent studies in 1931 (1), (2), (3), associating the presence of fluoride in the drinking water with the endemic hypoplasia of the permanent teeth know as mottled enamel, the question of what constitutes a permissible amount of fluoride in a domestic water suply frequently arises. Attempts to prevent the further development of this disease [fluorosis] by removing the toxic amounts of fluorides present in the water is naturally dependent upon reliable and definite information concerning this maximum, or minimal threshold.

    For public health purposes we have arbitrarily defined the minimal threshold of fluoride concentration in a domestic water supply as the highest concentration of fluoride incapable of producing a definite degree of mottled enamel in as much as 10 percent of the group examined.”

    So Ken where do you get your definition of “endemic”?

    Like

  31. Brian – I think you must check out the meaning of the word “endemic.” You will see it applies to parts of India and China with high natural levels of fluoride – it does not apply to NZ.

    Like

  32. I did check the meaning of the word, “endemic,” Ken. It just means regularly found.
    I think you are confusing “endemic dental fluorosis,” with “near universal dental fluorosis.”

    What rate of people would you have to see with a goitre before you would say the area has endemic goitre?

    Or if a society has 30% corruption what you say no only 30% does not make the corruption endemic.

    I think you are just trying to create a perception, aren’t you?

    Like

  33. Rather vague, but high fluoride levels are not “regularly fund” in NZ and most of the USA – they are in those areas of China and India described as suffering endemic fluorosis.

    I suspect that even Susheela might admit her mistake so I think you are silly to try to justify it.

    Like

  34. Ken: “There is no significant risk of skeletal or dental fluorosis of concern due to CWF, or natural levels of fluoride, in New Zealand.”

    Does that mean in combination with the bottom quintile of instruction of children in how much toothpaste to use, how old the child is and not swallowing/supervised?

    Like

  35. Brian, you are just being silly now. Susheela made a mistake with her mad (probably indicating her lack of knowledge of areas like NZ and Australia). If she has got any sense she would acknowledge that. In fact, I have been meaning to contact her to offer her a righty of reply so we may well see.

    Like

  36. Ken,
    I stand by everything I wrote in my original comment. The huge body of research in India on the chronic adverse effects of fluoride ingestion is indeed relevant. Of course, climate and diet vary from region to region, but reducing the previously standard fluoride concentration in drinking water from around 1 ppm to 0.75 ppm in New Zealand cannot eliminate the health hazards to people with high water intake (e.g. outdoor workers and athletes) or the inability to excrete fluoride due to kidney damage. You have avoided my key point that fluoride dose, not concentration, determines toxicity. A New Zealander who ingests on average 4 litres of fluoridated water per day at 0.75 ppm will ingest the same daily dose as an Indian who ingests 2 litres per day at 1.5 ppm. There is no safety margin and they are both at risk of skeletal fluorosis.

    Your statement that “we do not observe skeletal fluorosis in New Zealand” carries no weight, because there has been no expert study to investigate the disease in New Zealand (or Australia for that matter). Arthritis is a symptom of the first stage of skeletal fluorosis. Since the symptoms of arthritis can have several causes, a genuine scientific study to investigate the prevalence of skeletal fluorosis would start by x-ray examinations of the bones and joints of people with high water intakes or kidney disease together with arthritis at a relatively young age. This hasn’t been done.

    Your emotional dismissal of one of the fundamental concepts of toxicology, the safety margin, as “naïve”, demonstrates the ignorance of this discipline you share with the vast majority of dental proponents of fluoridation.

    The fact that there has never been a randomised controlled trial to investigate the alleged dental benefits of fluoridation, as confirmed by the Cochrane Report, shows that the scientific basis for the claims of huge benefits is shaky, to say the least. Your quotation of Cochrane’s feeble attempt to justify this situation does not logically change the weak scientific basis. Contrary to your misrepresentation of my previous comment, I take the position that all medications, including fluoride, should be subject to proper scientific testing of risks and alleged benefits, and that randomised controlled trials are the best way of doing this.

    Incidentally, fluoridation is medication, since fluoride is added to water to treat people, not to make the water safer to drink. The fact that fluoride is a natural substance does not remove it from being a medication, since many medications were originally natural substances, e.g. penicillin, aspirin and digitalis. Furthermore, fluoridation is medication with an uncontrolled dose, a violation of medical ethics.

    On the basis of your misrepresentation of my previous comments and your insinuation that I’m dishonest, I will not participate further in your blog.

    Like

  37. Ken: “Brian, you are just being silly now.”
    No, because fluoridated water is said to be aimed at the poor uneducated, isn’t it, who presumably won’t be so clued at supervising child tooth-brushing?
    In a pea size amount of toothpaste, there’s 0.3 mg of fluoride.
    In a large stripe of toothpaste, there’s 2.25 mg of fluoride.
    In one liter of fluoridated water, you’ll find 1 mg of fluoride.
    http://www.oralanswers.com/is-there-more-fluoride-in-a-pea-sized-amount-of-toothpaste-or-a-liter-of-water/

    I suggest the bottom 20% of of kids may not be adequately supervised against swallowing toothpaste. I suppose you will say I can’t back that up with research. Can you?

    How much water do you think a child should drink in hot weather therefore how many mg of fluoride are they going to get?

    Is the fluoridation level of Auckland water related to Dunedin correctly adjusted for summer temperatures?

    To what extent does the specified water fluoridation level allow for toothpaste swallowing?

    Like

  38. Mark, firstly let me say I am disappointed you have rejected the opportunity for a scientific discussion here. We each have the scientific credentials and backgrounds which could make such a discussion very informative as we can objectively analyse the claims of both sides and we have access to the scientific literature.

    Let me stress I am offering you space for unedited postings – subject only to the ordinary discussion on blog posts and the right of reply by a similar posting. I should also stress I have not called you dishonest, or insinuated that. I did say that your claim that the efficacy of community water fluoridisation is “unresolved scientifically” might lead some to say you are dishonest. After all, at first sight the claim appears preposterous to anyone who has studied the area. However, the beauty of an open scientific discussion along the lines I am offering is that you have the chance to support that claim with evidence and citations. My personal approach is to give you an opportunity to support the claim before I passed such a judgment.

    Come on, you might get me to change my mind if you reveal the evidence for your claim.

    Now some details from your comment:

    1: The question of “dose.” Of course, this is an emotive word and intentionally misleading as “dose” normally implies a medicine or drug. You reinforce that misleading concept by asserting that “fluoridation is medication.”

    Well, of course it isn’t. No more than the calcium in your drinking water (which also improves oral health, is a medicine. OK, you will say that is not intentionally added (because we usually don’t have a problem of Ca deficiency). Then what about iodised salt, calcium and vitamin enhanced milk, folate enhanced bread, etc. These intentional additions are aimed at maintaining health (b y overcoming a deficiency). We don’t call our milk, bread or salt a medicine. We don’t refer to “dose” – or the “problem of dose” – when discussing bread, salt or milk. Yet intake will vary from individual to individual. We don’t complain about the “uncontrolled dose” of iodine, calcium, vitamins, etc –that would be naïve.

    No, of course not. Health experts are concerned about nutrient intake. They recognise the intake has no need to be precise (unlike a drug, medicine or anaesthetic). And in most cases they go on ball-park figures when considering if a nutrient is deficient or not at the population level. Because the major source of fluoride for most people is drinking water (and that is something health experts check from time to time) it turns out that the concentration of fluoride in drinking water is a useful measurement. Of course, the sensible person also looks at other sources from specialised diets, industrial pollution, etc.

    2: The proof of the pudding is in the eating. Whether or not current recommendations for the concentration of fluoride in drinking water (or consideration of other food sources) are adequate is under constant review. And an important factor is the evidence for excessive intake as provided by cases of fluorosis. The proof of the pudding is in the eating – a basic scientific principle.

    You raise the issue of “risk of skeletal fluorosis” in NZ and Australia – because you cannot point to any cases of the affliction in these countries. They just don’t exist. In contrast people like Susheela and Xiang work with actual cases of skeletal fluorosis – because they are working in areas of endemic fluorosis.

    You are grasping at straws to assert that we do not observe skeletal fluorosis in NZ because we don’t look! Come off it – do you think our health system is so inadequate we would not recognise cases if they did occur? Hell, we have no problem identifying it in farm animals where it does occur.

    You then grasp at an even weaker straw by trying to claim arthritis as actually being skeletal fluorosis. But you seem to admit you have no evidence for this by implying the work “hasn’t been done.” This is an unfortunate tactic used by anti-fluoridationists – to claim possibilities as facts. That is not scientific – it is desperate wishful thinking.

    If I have judged you incorrectly on this then why not participate in the scientific exchange I am suggesting. You would have all the space you needed to give your evidence or citations rather than simply having to rely on unsubstantiated assertions.

    3: Dissing the Cochrane report. You consider the simple facts stated by the Cochrane report – that randomised controlled studies are not possible with a social health policy like community water fluoridation as “an attempt to justify the situation.” I suggest that your description is an attempt to discredit reality. Surely, if such trials were really possible they would have been done. If you disagree please outline the practical aspects of such a trial and we can discuss it.

    In fact, randomised controlled studies they have been done in the more limited situation of milk fluoridation. And laboratory studies have been done to check and demonstrate the mechanisms behind the beneficial effects of fluoridation.

    Finally, can I repeat my offer of an open scientific discussion between us? That is a genuine offer on my part. I know that I always learn from such exchanges and I think the readers here would also appreciate it.

    What about it?

    Like

  39. No, Brian, you are just continuing with your silliness.

    You object to my point that Susheela made a mistake in describing NZ as an area of endemic fluorosis. That judgement centres on the meaning of the word “endemic” which you wish to divert away from.

    Consider the fact that she did not include the USA as an area of endemic fluorosis. Why not? What is so different about NZ and USA?

    Do you really think she would refuse to acknowledge her mistake?

    Like

  40. Ken wrote: “Consider the fact that she did not include the USA as an area of endemic fluorosis.”

    Possibly thought it was all fixed. It was in Russia, too, which she hasn’t marked.

    http://www.ircwash.org/sites/default/files/245.4-9038.pdf
    “Animal bones, grounded and charred in order to remove the organic
    materials, can be used as bone char. Bone char was commercially used in Britton, South Dakota USA, from 1953 to 1971 to remove fluoride from drinking water.”

    Like

  41. Ken is trying to create the perception that Mark Diesendorf was trying to claim arthritis as actually being skeletal fluorosis.

    Or maybe Ken couldn’t understand.

    Mark: “Arthritis is a symptom of the first stage of skeletal fluorosis. Since the symptoms of arthritis can have several causes, a genuine scientific study to investigate the prevalence of skeletal fluorosis would start by x-ray examinations of the bones and joints of people with high water intakes or kidney disease together with arthritis at a relatively young age. This hasn’t been done. ”

    Mark claims SOME arthritis could really be the first stage of skeletal fluorosis. It is not an identity as Ken PRETENDS Mark was saying not only all skeletal fluorosis starts with arthritis, but all arthritis is the start of skeletal fluorosis.

    I have to add my own hypothesis about hip, knee or ankle arthritis: that poisoning of the gut microbiome by fluoride (when water is drunk too fast and the fluoride does not all get absorbed in the acidifying stomach F- => HF) and bowel gas increases putting pressure on arteries to the hip, knee and ankle, such as through the obturator foramen. Sports people drinking water fast could be at risk.

    Like

  42. Brian, before you comment further here could you spend some time coming to grips with the word “endemic.”

    Like

  43. Brian, could you allow Mark to speak for himself. He has been given the opportunity here to advance his ideas, produce the evidence and citations for them and to participate in a good faith scientific discussion.

    We don’t need you to pretend to speak for him.

    Like

  44. Ken: “Brian, before you comment further here could you spend some time coming to grips with the word “endemic.””

    From TeAra:
    “An endemic disease is continually present in a population at a low rate, or with a low death rate. An example of this in New Zealand in the 2000s was hepatitis B.”

    Like

  45. soundhill,

    “An endemic disease is continually present in a population at a low rate, or with a low death rate. An example of this in New Zealand in the 2000s was hepatitis B.”

    Around the East Cape up to 50% of the population had antibodies to hepatitis B. That’s an endemic disease.

    Now let us know what percentage of the NZ population demonstrates endemic fluorosis, citations required. Compare that with the incidence of hepatitis B before vaccination was introduced. Compare it with current incidence of hepatitis B now the disease is no longer endemic.

    Note the similarity of incidence of fluorosis in NZ to the incidence of (no longer endemic) hepatitis B in NZ.

    Your definition of endemic appears to be somewhat different to that of the rest of the world.

    Like

  46. Stuartg: “Around the East Cape up to 50% of the population had antibodies to hepatitis B. That’s an endemic disease.”

    “From Wikipedia, the free encyclopedia

    Pakistan is one of the two remaining countries[1][2] in the world where poliomyelitis (polio) is still categorized as an endemic viral infection,[3] the other being Afghanistan.[1] As of October 2015, there have been 38 documented cases of wild poliovirus in Pakistan in the past year.[4]”

    That is probably in an area of about 80 million people – something like 0.00005 percent.

    and I quoted before
    “In Auckland, New Zealand, Cutress et al. found that diffuse enamel opacities occurred more frequently in fluoridated than nonfluoridated areas (P<O.OOl), with a mouth prevalence of 19 percent in the fluoridated areas, but only 8 percent in the nonfluoridated areas."

    Like

  47. Ken: “Brian, could you allow Mark to speak for himself. He has been given the opportunity here to advance his ideas, produce the evidence and citations for them and to participate in a good faith scientific discussion.

    We don’t need you to pretend to speak for him.”

    He and a lot of other people are suspicious of your manner of expression. You talk of my “silliness,” and I have learned to come back at you with reason, whereas many people just can’t be bothered combating that level of perception-creation.

    Like

  48. It is silly to pretend to speak for others – and to divert away from the key meaning of “endemic.”

    But I do get pissed off with your habit of intruding on discussion like this with meaningless drivel. 🙂

    Liked by 1 person

  49. Ken, there is an affliction called synaesthesia in which the infant combined senses do not differentiate properly and the patient forever associates numbers or words with colours &c.

    I think you like the demonic sound power of “demic” in “epidemic” and “pandemic” and in your mind that power spills over to “endemic.”

    “Demos” is a people or region.
    “Epi” is “a prefix occurring in loanwords from Greek, where it meant “upon,” “on,” “over,” “near,” “at,” “before,” “after””

    “Pan” means “all”, and pandemic not staying just in one region.

    “En” means “in”.

    Try these words, “hyperendemic,” “holoendemic.”

    Like

  50. No, Brian, you are being silly. You are just avoiding what is staring you in the face – Sasheela made a mistake in claiming NZ is an area of endemic fluorosis.

    Like

  51. Ken, the fluorosis countries on the map don’t have have higher fluoride ground water all over. If there are some areas with fluorosis in a country it is all marked blue, which is really a mistake in my viewpoint, them only doing some sort of averaging. Or does nature some how stick to the man-made border between Senegal and it surrounding countries?

    I suppose it is possible Susheela may be coning here primed up to talk about greater fluorosis than there is in New Zealand. Then FFNZ may be thanking you for getting that sorted before her visit.

    I have talked about dental fluorosis, though the map is not just about dental.

    As mark suggested we ought to do observational (arthritis) science, especially of people working in the fertiliser factories or living near them since nearby residents lose garden plants and windows get frosted by the fluoride in the air. Though Susheela did not use the word arthritis, just inflammation. Unlike dental fluorosis, which happens with exposure in the early years, irreversible skeletal fluorosis can occur at any time of life under exposure.

    The question is why some people are more susceptible – is it more than just poor toothpaste technique and too much tea drinking? Is it in their genes or epigenetics? Then rather than blaming the sufferer and telling them to stop complaining and suggesting nothing to be wrong with their difference, and looking like a propaganda stooge you ought to be apologising to them having to bear the burden for what you believe to be the good of the others.
    And you should be making an attempt to find out who may be susceptible.
    How can people themselves be expected to know?

    You seem to want to insinuate that “endemic fluorosis” is only related to naturally occurring higher levels of fluoride in water supplies. Lower calcium (hardness) can also affect it, though that may be adjusted by the processer to stop pipe or tap corrosion. But then maybe kids who can’t take milk owing to allergy or intolerance will be lower on dietary calcium, too. So top-up fluoridation is going to affect people differently.

    Susheela wrote:
    “We purposely fluoridate a
    range of everyday products, notably
    toothpaste and drinking water, because
    for decades we have believed that fluoride
    in small doses has no adverse effects
    on health to offset its proven benefits in
    preventing dental decay. But more and
    more scientists are now seriously questioning
    the benefits of fluoride, even in
    small amounts.”

    Meaning that old dogma needs a fresh look.

    Like

  52. See, Brian, this is why your comments are so disingenuous and childish. You are not using reason, you are simply attempting to divert or derail and reasoned discussion – while blatantly and cynically using comments sections of my blog for your pro-Mercola and pro-big business (the “natural/alternative health big business) interests.

    You are welcome to get your own blog and promote your lies and business interests there – but I am sick and tired of you taking advantage of the lack of my lack of censorship to do so here. I guess the openness enables you to provide examples which end up turning people off your claims.

    The map did not claim that the countries marked blue had “higher fluoride ground water all over.” Such maps are perfectly normal (to show countries with a problem) and only a dishonest person would attempt to misrepresent them in that way.

    The FFNZ should be grateful to me for lots of things where I have shown their propaganda to be false – but they aren’t. They purposely censor any comments from me or like minded people because they wish to promote misinformation and distortion. They do that knowingly – they don’t want that exposed.

    As for propaganda stooge – well we know who that description fits here, don’t we?

    Like

  53. Ken, people feel they can’t trust authority science. Please take a look at what the EPA administrator was telling the public about the safety of New York air after 9/11, knowing it wasn’t true.

    I am suggesting that governments override truth for their agenda and who knows whether it happens with fluoridation?

    I actually believe by not answering many of my comments but just labeling them that you are uneasy about your position.

    Like

  54. I thought I was posting the link to the EPA administrator episode in this series Christine Todd Whitman.

    Like

  55. Sandle is a 9/11 troofer.
    My, my, who would have thought?

    Like

  56. Richard in this case I am relating about the “scientific” advice that the air is harmless that Whitman gave out. People trusted that government science which was not good enough.

    Now Whitman has apologised.

    https://www.theguardian.com/us-news/2016/sep/10/epa-head-wrong-911-air-safe-new-york-christine-todd-whitman

    Some people are wondering if one day there may be an apology about government science relating to fluoride. There is the waste disposal parallel.

    Like

  57. “Some people are wondering if one day there may be an apology about government science relating to fluoride.” = “FFNZ and myself are wondering…”

    Like

  58. More relevant, seeing the anti-human results of tooth decay -I wonder why there are not apologies today from local body councillors who have prevented introduction of a safe and effective social health policy capable of reducing tooth decay.

    But politicians (and ideologically driven activists) are no well known for apologising. Hell, ever seen Brian apologise for one of his many mistakes or misrepresentations. 🙂

    Like

  59. When I was at secondary school we had military cadet training. I used to spend quite a lot of time going for uniform changes. What was wrong, my size or the small number of larger size shorts available? Or is it a bit of both? I know you will want it simple, Stuartg.

    Like

  60. “What was wrong?”

    The militaristic cadet system.

    Like

  61. I was trying to draw a parallel between too few clothing sizes available, with too little knowledge to get fluoride dose correct for varying needs. Many probably have no idea about what fluoride is/does. I never thought it might have been a trouble, or thought about it at all.

    I think I was intelligent enough to realise very tight shorts could be a trouble
    with abdominal pain.

    Like

  62. “…too little knowledge to get fluoride dose correct for varying needs.”

    Dosage is only needed for medicines. CWF is not a medicine, as has been decided by multiple courts worldwide. So, no “dose” to get “correct”.

    By observing millions of people, over multiple decades and multiple generations, the only effect of CWF at current concentrations able to be demonstrated is a reduction of the amount of dental caries in populations with CWF.

    Like

  63. soundhill,

    As you commented, hepatitis B used to be endemic in NZ. Since the introduction of widespread vaccination against hepatitis B it no longer is.

    It’s incidence in NZ now is low, about the same as fluorosis. If hepatitis B is no longer endemic, why do you label a similar incidence of fluorosis in NZ as endemic?

    The only other person who does so is Sasheela (not even Mercola…), and her labeling is demonstrably a mistake.

    (Nice diversion from answering Ken’s question about your meaning of endemic, btw)

    Like

  64. As usual Stuartg is trying to put clever definitions on terms
    So he is big on that a recommended daily allowance is not a dose.
    Wikipedia:
    “Dose means quantity (in units of energy/mass) in the fields of nutrition, medicine, and toxicology”

    But I say nastily that doctors do not acknowledge nutrition and nutritional doses without a big fight. So Stuartg doesn’t care how much fluoride an uneducated family is giving a baby, or a child low on calcium.

    Age Recommended daily fluoride amount
    (miligrams) maximum daily amount
    (miligrams)
    Male 3,8 10
    Women 3,1 10
    Baby
    (6-12 months) 0,5 0,9
    Children
    (4-8 years) 1,1 2,2
    Children
    (9-13 years) 2,0 10
    http://www.mineravita.com/en/fluoride-rda.html

    (The commas are a continental way of indicating decimal points.)

    Like

  65. Stuartg: “By observing millions of people, over multiple decades and multiple generations, the only effect of CWF at current concentrations able to be demonstrated is a reduction of the amount of dental caries in populations with CWF.”

    Stuartg’s motto: When observing don’t notice anything outside of policy unless very profitable.

    Mark has pointed out observation of young-person joint inflammation is lacking.

    Like

  66. Stuartg where is your definition of endemic because it does’t agree with CDC?
    http://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section11.html

    Like

  67. soundhill,

    You have previously said that you do not have an opinion, that you are merely questioning both sides of a theory.

    How do your last comments reflect your claimed objectivism?

    Attacking people who point out the flaws in your fantasies does not reflect well on your claims of objectivism.

    It doesn’t answer Ken’s question about what you mean by endemic, either.

    Sasheela (as well as yourself) is mistaken in her opinion that fluorosis is endemic in NZ. Groundwater fluoride levels in NZ are nowhere near those of areas where endemic fluorosis occurs (apart from – possibly – Tongariro http://www.weatherwatch.co.nz/content/potentially-toxic-fluorine-found-tongariro-ash ) https://en.m.wikipedia.org/wiki/Fluoride_toxicity

    Around the world, CWF has been in place for many decades, for multiple generations, and many millions of people have been exposed to it, including some of the most documented populations worldwide.
    http://www.nidcr.nih.gov/oralhealth/Topics/Fluoride/TheStoryofFluoridation.htm
    http://www.fluoridefacts.govt.nz/fluoride-facts

    The numbers are out there, the documentation is out there. If there have been any adverse effects from CWF in the past sixty years, as you claim, then show us the documentation.

    Like

  68. soundhill,

    Interesting citation. It points out that the endemic level of a disease in a population can actually be zero.

    By that definition, the essentially zero level of fluorosis found in NZ is the endemic level in NZ.

    Like

  69. soundhill,

    “Mark has pointed out observation of young-person joint inflammation is lacking (sic).”

    And I’ll point out that observations of young persons flying without mechanical assistance is also lacking…

    Like

  70. Stuartg wrote (that I wrote):“Mark has pointed out observation of young-person joint inflammation is lacking (sic).
    Stuartg wrote: “And I’ll point out that observations of young persons flying without mechanical assistance is also lacking…”

    Mark had written: ”Arthritis is a symptom of the first stage of skeletal fluorosis.”

    OK a if a youngish person gets arthritis it should be investigated. One of the things it may be is early-stage fluorosis.

    Mark: “Since the symptoms of arthritis can have several causes, a genuine scientific study to investigate the prevalence of skeletal fluorosis would start by x-ray examinations of the bones and joints of people with high water intakes […often male sports players…] or kidney disease together with arthritis at a relatively young age. This hasn’t been done.”

    Stuartg thinks it would have been noticed if occurring. Do you know of anyone commenting on their wonderingsabout this matter, Stuartg? Or haven’t many wondered hard enough to get motivated to apply for a grant to study it?

    Like

  71. Stuartg wrote: “Interesting citation. It points out that the endemic level of a disease in a population can actually be zero.

    By that definition, the essentially zero level of fluorosis found in NZ is the endemic level in NZ.”

    Stuartg was thinking of this part about “endemic level of disease” not “endemic disease.”
    “The amount of a particular disease that is usually present in a community is referred to as the baseline or endemic level of the disease.”

    They repeat that in the “or” part of this:
    “Endemic refers to the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.”
    But note the first part: “Endemic refers to the constant presence,” in other words endemic fluorosis is a disease, according to CDC, that is constantly present in a population or geographic area.

    Note they also define: “Hyperendemic refers to persistent, high levels of disease occurrence.” So there could be hyperendemic mild fluorosis.

    In parts of some countries there can be hyperendemic severe fluorosis.

    Like

  72. soundhill,

    For a disease to be endemic, it has to be present in a population.

    Show us the documented incidence of skeletal fluorosis in NZ.

    No speculations or maybes. The actual incidence.

    Until you do that, your comments remain pie-in-the-sky speculation.

    Like

  73. soundhill,

    You are making definitive statements about what I think when you have absolutely no knowledge of my actual thoughts.

    The entire of the data you possess are written in my comments. From that data you make invalid extrapolations based on unsubstantiated assumptions, which you subsequently treat as though they are facts. https://thelogicofscience.com/2016/11/07/dont-mistake-an-assumption-for-a-fact/

    You have previously told us that your version of science is different to everyone else’s; that you have never received tuition but are self taught about science. That is becoming increasingly more obvious.

    I have previously counseled that you take a high school course in science as your muddled thinking would probably benefit from it. Another suggestion would be that you read “Bad Science” by Ben Goldacre.

    Unfortunately, I don’t expect you to follow either of these recommendations as you appear totally unable to perceive your own lack of knowledge and education in the fields you ramble on about.

    Like

  74. “From that data you make invalid extrapolations based on unsubstantiated assumptions, which you subsequently treat as though they are facts.”

    Now in the following Mercola page please note there is a difference between refusing vaccines for people demonstrated to be harmed by them from those not known too be harmed by them.

    The courts have sometimes given doctors the power to treat based on a belief rather than scientific fact..

    Stuartg, yes I did think you were simplifying by referring to only one part of the CDC explanation of use of the word “endemic.” Please explain your actual position.

    http://articles.mercola.com/sites/articles/archive/2016/11/15/forced-vaccination.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20161115Z3&et_cid=DM125850&et_rid=1754857070

    Like

  75. Hmmm….

    Diversion by soundhill again.

    Unable to tell us if there actually is an incidence of skeletal fluorosis in NZ, so he’s trying to divert rather than acknowledging skeletal fluorosis is not endemic in NZ.

    Like

  76. soundhill,

    Since you’re the one using the term “endemic” in the thread, you’re the one who needs to define how you use the term. Not me, not Ken, not anyone else.

    Especially since you appear to use a different definition of endemic than that used by the rest of the world.

    Like

  77. “Unable to tell us if there actually is an incidence of skeletal fluorosis in NZ, so he’s trying to divert rather than acknowledging skeletal fluorosis is not endemic in NZ.”

    Stuartg if you were examining an x-ray how obvious would radio-dense lines in bones have to be before you would report them/notice them?

    Like

  78. And yet another attempt at diversion to avoid acknowledging that skeletal fluorosis is not endemic in NZ…

    Like

  79. Mark’s point is that we haven’t taken note. I ask at what point we take note. Is it changing, as with the program against measles which used to be a normal disease, and now is almost quarantine-able? Are we still at an early stage where radio-dense striations on bones are not bothered with?

    Like

Leave a Reply: please be polite to other commenters & no ad hominems.

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s